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Open image in new window Fig. 11 Bronchiectasis due to recurrent aspiration.
Laryngotracheal isolation under general anesthesia was planned due to recurrent aspiration pneumonia.
In the authors' experience, recurrent aspiration also appears to be a risk factor.
The distended oesophagus and the propensity for reflux predisposes these patients to recurrent aspiration events (Fig. 3a and b).
Clinical concern for a TE fistula should be raised in a patient with oesophageal carcinoma and recurrent aspiration pneumonia [29].
Recurrent aspiration with subsequent infection/inflammation causes both direct and indirect damage to the airways and can lead to peripheral and dependent lower lung-predominant bronchiectasis.
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And one had repeated aspiration pneumonia owing to recurrent nerve palsy.
Gastro-oesophageal reflux is common and dysphagia (10%%) may cause recurrent silent aspiration and pneumonia.
Extraoesophageal manifestations of GER in children (atypical symptoms) include laryngitis, pharyngitis, sinusitis, otitis media, rinit, and pulmonary symptoms such as asthma, chronic cough and recurrent pulmonary aspiration [ 3- 7].
Previous studies have demonstrated that recurrent vomiting, aspiration and/or failure to thrive may be present in as many as 10 15% of institutionalized patients with psychomotor retardation.
It is important not to forget that persistent endobronchial infections occur in other conditions known to cause chronic coughing including cystic fibrosis, immune deficiencies, primary ciliary dyskinesia and recurrent pulmonary aspiration.
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